Procedural Post-Operative Instructions

Gallbladder Post-Operative Instructions

Laparoscopic Cholecystectomy

Activity

Laparoscopic gallbladder surgery causes less damage to the muscles and other tissues than a standard gallbladder surgery incision. For this reason, there are fewer restrictions on your physical activity than might be expected.

Walking: Walking is permitted and encouraged beginning within hours of your operation. Start with short walks and gradually increase the distance and length of time that you walk.

Climbing: Climbing stairs is permitted. Initially, some assistance may be necessary.

Lifting: No lifting greater than 10 pounds for six weeks.

Showers: Showers are permitted two days after surgery. Be careful to clean your incision (steri-strips and all), with a mild soap. Rinse well and pat dry.

Driving: Driving may be resumed 3-5 days following surgery, but not if you are still taking prescription pain medications.

Sex: Sex may be resumed two days after surgery.

Wound Care

Sutures / Staples: Typically dissolvable sutures are placed just beneath the surface of the incision. The material is absorbed by your body in about 6 weeks and does not need to be removed. Occasionally, a small white string is evident at an incision site a few weeks after surgery. This string can be cut at the surface of the skin using a clean pair of scissors (wipe with isopropyl alcohol prior to cutting). If Staples are used, they will be removed 5-10 days after surgery in the office.

Steri-Strips / Butterfly Tapes: Steri-strips may be removed as they begin to lift off the wound. If they have not already done so, they may be completely removed 10 days after surgery. Moisten the strips with a little peroxide if they are stuck to the incision.

Diet

There are generally no dietary restrictions following surgery. Foods which cause you discomfort or do not agree with you should be avoided. Most patients find that they are able to eat many foods that they were not able to tolerate prior to surgery. Gradually introduce these items to your diet and determine how well you tolerate them.

Medications

Pain: Your physician will prescribe narcotic pain medications after surgery. These are typically only needed for a day or two, thereafter we recommend Extra Strength Tylenol or Advil for mild to moderate pain. Do not take the presciption pain medicine along with over the counter medications. Call us if you have any questions.

RETURN TO WORK

Most patients will be able to return to work or resume their usual level of function 7-10 days after surgery. This may need to be determined by you and your employer. Some patients have residual fatigue for a couple of weeks following general anesthesia.

PRINCETON SURGICAL SPECIALISTS, P.C.

Laparoscopic Nissen Fundoplication

Activity

Laparoscopic Nissen Fundoplication surgery causes less damage to the muscles and other tissues than a traditional incision. For this reason, there are fewer restrictions on your physical activity than might be expected.

Walking: Walking is permitted and encouraged beginning within hours of your operation. Start with short walks and gradually increase the distance and length of time that you walk.

Climbing: Climbing stairs is permitted. Initially, some assistance may be necessary.

Lifting: No lifting greater than 10 pounds for six weeks.

Showers: Showers are permitted two days after surgery. Be careful to clean your incision (steri-strips and all), with a mild soap. Rinse well and pat dry.

Driving: Driving may be resumed 3-5 days following surgery, but not if you are still taking prescription pain medications.

Sex: Sex may be resumed two days after surgery.

Wound Care

Sutures / Staples: Typically dissolvable sutures are placed just beneath the surface of the incision. The material is absorbed by your body in about 6 weeks and does not need to be removed. Occasionally, a small white string is evident at an incision site a few weeks after surgery. This string can be cut at the surface of the skin using a clean pair of scissors (wipe with isopropyl alcohol prior to cutting). If Staples are used, they will be removed 5-10 days after surgery in the office.

Steri-Strips / Butterfly Tapes: Steri-strips may be removed as they begin to lift off the wound. If they have not already done so, they may be completely removed 10 days after surgery. Moisten the strips with a little peroxide if they are stuck to the incision.

Diet

Swelling at the operative site can cause some foods to get stuck, which can become an emergency. Adhering to this diet will prevent that from happening.

After surgery a Liquid/thick diet includes such things as milkshakes, puddings, soups, mashed potatoes, etc. If you tolerate this without any problems you can gradually (over several days/weeks) advance to soft foods, or things that will go down easily (tuna fish, pasta, soft vegetables, etc.). Avoid breads, bagels, meats, and raw vegetables that may be difficult to swallow for a few weeks. The last foods you will reintroduce into your diet are breads and meats (3-6 weeks). You will avoid carbonated beverages after surgery because they can result in uncomfortable gas bloating which can be serious in some situations.

Medications

Pain: Your physician will prescribe narcotic pain medications after surgery. These are typically only needed for a day or two, thereafter we recommend Extra Strength Tylenol or Advil for mild to moderate pain. DO NOT take the prescription pain medicine along with over the counter medications. Call us if you have any questions.

RETURN TO WORK

Most patients will be able to return to work or resume their usual level of function 7-10 days after surgery. This may need to be determined by you and your employer. Some patients have residual fatigue for a couple of weeks following general anesthesia.

PRINCETON SURGICAL SPECIALISTS, P.C.

Laparoscopic Hernia Repair

Activity

Laparoscopic Hernia Repair Surgery causes less damage to the muscles and other tissues than standard traditional (open) surgery. For this reason, there are fewer restrictions on your physical activity than might be expected.

Walking: Walking is permitted and encouraged beginning within hours of your operation. Start with short walks and gradually increase the distance and length of time that you walk.

Climbing: Climbing stairs is permitted. Initially, some assistance may be necessary.

Lifting: No lifting greater than 10 pounds for six weeks.

Showers: Showers are permitted two days after surgery. Be careful to clean your incision (steri-strips and all), with a mild soap. Rinse well and pat dry.

Driving: Driving may be resumed 3-5 days following surgery, but not if you are still taking prescription pain medications.

Sex: Sex may be resumed two days after surgery.

Wound Care

Sutures / Staples: Typically dissolvable sutures are placed just beneath the surface of the incision. The material is absorbed by your body in about 6 weeks and does not need to be removed. Occasionally, a small white string is evident at an incision site a few weeks after surgery. This string can be cut at the surface of the skin using a clean pair of scissors (wipe with isopropyl alcohol prior to cutting). If Staples are used, they will be removed 5-10 days after surgery in the office.

Steri-Strips / Butterfly Tapes: Steri-strips may be removed as they begin to lift off the wound. If they have not already done so, they may be completely removed 10 days after surgery. Moisten the strips with a little peroxide if they are stuck to the incision.

Bruising / Swelling: It is not unusual for some swelling and bruising in the groin area. An athletic supporter may help. If swelling occurs, elevation and rest is recommended. Dark discoloration in the groin and scrotum is temporary if it occurs. Call the office for severe swelling or bruising.

Diet

There are generally no dietary restrictions following surgery. Foods which cause you discomfort or do not agree with you should be avoided.

Medications

Pain: Your physician will prescribe narcotic pain medications after surgery. These are typically only needed for a day or two, thereafter Extra Strength Tylenol or Advil for mild to moderate pain for 1-2 weeks is recommended. DO NOT take the prescription pain medicine along with over the counter medications. Call us if you have any questions.

RETURN TO WORK

Most patients will be able to return to work or resume their usual level of function 7-10 days after surgery, with a restriction of not being able to lift anything weighing more than 10 pounds for six weeks. Some patients have residual fatigue for a couple of weeks following general anesthesia.

PRINCETON SURGICAL SPECIALISTS, P.C.

Activity

Walking: Walking is permitted and encouraged beginning within hours of your operation. Start with short walks and gradually increase the distance and length of time that you walk. You are encouraged to be up and around as much as possible.

Climbing: Climbing stairs is permitted. Initially, some assistance may be necessary.

Lifting: No lifting anything heavier than a gallon of milk (10 pounds) for two weeks.

Showers: It is ok to remove your dressing and shower on the second day or 48 hours after your surgery if there is no drain in place. Pat the incision dry with a town and leave uncovered.

Driving: Driving may be resumed 3-5 days following surgery, but not if you are still taking prescription pain medications. Do not drive until you are off pain medication and able to steer, press the brakes, etc. without pain.

Sex: Sex may be resumed two days after surgery.

Wound Care

Sutures / Staples: Typically dissolvable sutures are placed just beneath the surface of the incision. The material is absorbed by your body in about 6 weeks and does not need to be removed. Occasionally, a small white string is evident at an incision site a few weeks after surgery. This string can be cut at the surface of the skin using a clean pair of scissors (wipe with isopropyl alcohol prior to cutting). If Staples are used, they will be removed 5-10 days after surgery in the office. If you have staples in place it is ok to leave them uncovered. If you wish to prevent the staples from catching on your clothes, it is ok to cover the incision with a dry gauze and tape.

Bruising: Some bruising around the incision is normal, and shouldn’t be cause for concern.

Diet

There are generally no dietary restrictions following surgery. Foods which cause you discomfort or do not agree with you should be avoided.

Drain Care

Please ensure to adhere to the following until given different guidance during your follow-up:

Clean around the drain site daily with hydrogen peroxide.

Do not shower or immerse the drain site in water.

Empty the drain and recharge the drain as instructed at least once daily. If the drain becomes full, empty it as needed. record the amount of drainage each time you empty it.

RETURN TO WORK

Most patients will be able to return to work or resume their usual level of function 7-10 days after surgery, with a restriction of not being able to lift anything weighing more than 10 pounds for two weeks. Some patients have residual fatigue for a couple of weeks following general anesthesia.

PRINCETON SURGICAL SPECIALISTS, P.C.

Activity

Walking: Walking is permitted and encouraged beginning within hours of your operation. Start with short walks and gradually increase the distance and length of time that you walk. You are encouraged to be up and around as much as possible.

Climbing: Climbing stairs is permitted. Initially, some assistance may be necessary.

Lifting: No lifting anything heavier than a gallon of milk (10 pounds) for one week.

Showers: It is ok to remove your dressing and shower on the second day or 48 hours after your surgery if there is no drain in place. Pat the incision dry with a towel and leave uncovered.

Driving: Driving may be resumed 3-5 days following surgery, but not if you are still taking prescription pain medications. Do not drive until you are off pain medication and able to steer, press the brakes, etc. without pain.

Sex: Sex may be resumed two days after surgery.

Diet

There are generally no dietary restrictions following surgery. Foods which cause you discomfort or do not agree with you should be avoided.

SPECIAL NOTE

Low calcium can develop temporarily after thyroid or parathyroid surgery. If you develop any numbness or tingling around the mouth or in your hands, take 4 or 5 TUMS or other calcium-containing antacid. Repeat with 4 or 5 more TUMS if needed. If the symptoms persist, call the office.

RETURN TO WORK

Most patients will be able to return to work or resume their usual level of function 7-10 days after surgery. Some patients have residual fatigue for a couple of weeks following general anesthesia.

PRINCETON SURGICAL SPECIALISTS, P.C.

Laparoscopic Appendectomy

Activity

Walking: Walking is permitted and encouraged beginning within hours of your operation. Start with short walks and gradually increase the distance and length of time that you walk. You are encouraged to be up and around as much as possible.

Climbing: Climbing stairs is permitted. Initially, some assistance may be necessary.

Lifting: No lifting anything heavier than a gallon of milk (10 pounds) for two weeks.

Driving: Driving may be resumed 3-5 days following surgery, but not if you are still taking prescription pain medications. Do not drive until you are off pain medication and able to steer, press the brakes, etc. without pain.

Sex: Sex may be resumed two days after surgery.

Wound Care

Please take special note of the following guidance for wound care:

It is ok to shower the day after your operation. Let the water hit and bounce off the steri-strip bandages. Pat yourself dry with a towel.

Do not take a tub bath.

Peel off the steri-strip bandages in five days and leave the wounds uncovered.

Some bruising around the incisions is normal.

Diet

There are generally no dietary restrictions following surgery. Foods which cause you discomfort or do not agree with you should be avoided.

RETURN TO WORK

Most patients will be able to return to work or resume their usual level of function 7-10 days after surgery, with a restriction of not being able to lift anything weighing more than 10 pounds for two weeks. Some patients have residual fatigue for a couple of weeks following general anesthesia.

PRINCETON SURGICAL SPECIALISTS, P.C.

Your recovery depends mainly on your type of procedure, why you had surgery, your previous health status and activity level. Most patients require between four and six weeks to completely recover. It is not unusual to experience a decreased appetite, fatigue, poor sleep, and depressed mood during this recovery period.

Activity

Walking: Walking is permitted and encouraged beginning within hours of your operation. Start with short walks and gradually increase the distance and length of time that you walk.

Climbing: Climbing stairs is permitted. Initially, some assistance may be necessary.

Lifting: No lifting greater than 10 pounds for six weeks.

Showers: Showers are permitted two days after surgery. Be careful to clean your incision (even the staples), with a mild soap. Rinse well and pat dry. Do not soak in a tub until ok’d by your doctor.

Driving: Driving may be resumed 3-5 days following surgery, but not if you are still taking prescription pain medications.

Sex: Sex may be resumed two days after surgery.

Wound Care

Staples: If Staples are used, they will be removed 7-14 days after surgery.
Open wound. If you have an open wound, you and your family will be taught to gently pack the wound with moistened gauze using either saline or tap water. This is usually needed 2-3 times a day. A home care nurse may visit you to assist with your wound care and bring supplies. (This varies depending on your health insurance.) Other wound care options may be recommended by your surgeon.

Oral Diet

There are a number of syndromes that are related to removal of a portion of the stomach in a Whipple procedure that effect some patients. These include Dumping syndrome, fat maldigestion, gastric stasis, and lactose intolerance. Foods which cause you discomfort or do not agree with you should be avoided. Initially, we recommend a diet to avoid symptoms related to loss of a portion of the stomach:

Eat 6 or more small meals/snacks a day.

Eat slowly and chew all foods thoroughly.

Sit upright while eating.

No carbonated beverages.

If you have difficulty maintaining your weight, you may need to drink a nutritional supplement for extra calories. You can try low-sugar over-the-counter supplements. These include no-sugar added Carnation Instant Breakfast, sugar-free Nutrishakes or Glucerna weight loss shakes.

Feeding Tube

Some patients are unable to tolerate an oral diet immediately after surgery. You may have a feeding tube placed at the time of surgery; or require one afterwards to support your nutritional needs. Feeding tubes need to be flushed with 30cc of water 3 times a day; and 30-60cc of Coca-Cola once a day to prevent clogging.

Drains

Temporary drainage tubes are used to remove dangerous secretions from your body in the event an anastamosis (internal connection of stomach, intestine, pancreas, or bile duct) has trouble healing, and leaks. If you are sent home with a drain in place, you will be instructed to clean around the drain site daily; as well as measure and record the drain output. You will bring a diary of the recorded daily output to your follow-up visits in the office.

Medications

Pain: Your physician will prescribe narcotic pain medications after surgery. Tylenol, Aleve or Advil are good non-narcotic ‘over the counter’ alternatives for post-operative pain. However, Tylenol over dosage can happen if you take Tylenol along with a prescription containing Tylenol (acetaminophen). Tylenol over dosage and resulting liver toxicity can be fatal. Call us if you have any questions.

Stool Softener: A stool softener or mild laxative may be necessary if you do not have spontaneous bowel movements with regularity. Narcotic pain medication will worsen constipation. Call the office if needed.

Insulin: Good blood sugar control in the post-operative period decreases the risk of complications after surgery. You will likely receive insulin while in the hospital; but if you were not on insulin before the surgery you are unlikely to require insulin after discharge from the hospital.

Pancreatic enzyme supplementation: If you experience steatorrhea (fat malabsorption; loose malodorous stools that float on water) you may benefit from this medication.

Gastric motility agents: Reglan and Erythromycin are used to accelerate stomach emptying in patients who develop gastric stasis after this surgery.

RETURN TO WORK

Most patients will be able to return to work or resume their usual level of function six weeks after surgery.

Princeton Surgical Specialists, PC

833 Princeton Ave SW

Suite 200-F, POB 3

Birmingham, AL 35211

(205) 776-8600(205) 776-8603 Fax

About Us

The surgeons of Princeton Surgical Specialists, P.C. each have a unique specialty focus and expertise beyond General Surgery. Through intensive preparation and dedication, our surgeons utilize the most current therapies and techniques to improve the lives of our patients. This allows us to maintain the highest standard of care available.